Biological Psychiatry

Biological psychiatry has dominated psychiatric thinking for the past 40 years, but the knowledge base of the discipline has increased substantially more recently, particularly with advances in genetics and neuroimaging. The third edition of Biological Psychiatry has been thoroughly updated taking into account these developments. As in the earlier editions of the book, there are comprehensive reviews and explanations of the latest advances in neurochemistry, neuroanatomy, genetics and brain imaging— descriptions not only of methodologies but also of the application of these in clinical settings. It is within this context that there is a considerable emphasis in the book on brain–behaviour relationships both within and without the clinical setting. This edition has been enhanced by the inclusion of new chapters, one on anxiety and another on motivation and the addictions. The chapter that relates to treatments has been extended to include the latest information on brain stimulation techniques. The overall book is well illustrated in order to help with an understanding of the text. For the third edition, Professor Michael Trimble has been joined by Professor Mark George as co-author. These are two of the world's leading biological psychiatrists who both have considerable clinical as well as research experience which they have brought to the book. Unlike multiauthored texts, it has a continuity running through it which aids understanding and prevents repetition. This book is strongly recommended for all practising psychiatrists and trainees wishing for an up-to-date, authoritative, easy to digest and acessible review of the latest advances and conceptualizations in the field. It will also appeal to neurologists interested in neuropsychiatry and biological psychiatry or the psychiatric aspects of neurological disorders, as well as other practising clinicians (psychologists, social workers, nurses) in the mental health field.

A Textbook of Biological Psychiatry integrates the basic science concerning brain mechanisms of psychiatric disorders alongside surveys of present standard clinical treatment. Organized in a coherent and easy to follow structure, chapters expand across different levels of analysis, from basic mechanisms to clinical practice. This comprehensive reference provides an integrative treatment of the biochemistry of neurotransmission, behavioral pharmacology, and clinical aspects of psychiatric problems including depression, manic-depression, and mood disorders. Other chapters address the biological mechanisms and treatment of depression, anxiety, panic, obsessive-compulsive disorder, and addictions. The editor concludes with a perspective on the future of the field and prospects for understanding and effectively treating mood and anxiety disorders.

Beginning with a tour of the brain, Dr. Hedaya explains how the brain works and how brain function relates to physical symptoms and cognitive and emotional well-being. He explains how biological psychiatrists consider the biology of the individual as an integral part of the whole picture and demonstrates a new way of conceptualizing clinical problems. Understanding Biological Psychiatry provides information in three basic areas: Chapters 1 and 2 outline basic scientific foundations and core concepts in biological psychiatry; chapters 3 and 4 review biological theories and medical mimics of the major psychiatric disorders; chapters 5 and 6 discuss medication and practical issues, including the basics of psychotropic medications and their role in the biopsychosocial approach. At the heart of this book is the author's proposal for a working alliance between therapists and psychiatrists - an important goal in today's growing managed care environment. The book has a practical bent, discussing, for example, when and how to refer to a psychiatrist, even describing how to explain this new perspective to a patient. The author's conversational style, as well as many figures, tables, and case illustrations, makes Understanding Biological Psychiatry a guide that is sure to be well-read and often referred to by therapists and physicians, as well as psychiatrists wanting to brush up on the biology of the mind.

It is now widely recognised that biological psychiatry is rapidly coming into its own. For over the last three decades dramatic advances in this young discipline have been made, all of which attest to the staying power of the experimental method. Those who made this revolution in knowledge happen are a breed of investigators availing themselves of the tools of molecular biology, pharmacology, genetics, and perhaps, above all, the technology of neuroimaging. The introduction of the interdisciplinary method of approach to the study of psychopathology had made it very clear that neuroimaging, as a set of techniques, is unique in that it is gradually providing us with evidence supporting Kraepelin's original view that mental illness is closely associated with abnormal changes in the brain. Broadly speaking, there are presently two structural techniques in neuroimaging - computed tomography and magnetic resonance imaging (MRI) - and three functional techniques - single photon emission tomography (SPECT), positron emission tomography and magnetic resonance imaging (fMRI). Through PET technology, for example, we have learned that, in early brain development, the primitive areas, mostly the brain stem and thalamus, are the first to show high activity in an infant. This is followed by the development of cortical areas by year one. Between the ages of four to 10, the cortex is almost twice as active in the child as in the adult. This information alerts us to what might happen in the way of trauma in abused children, especially those under the age of three. Child abuse increases the risk of physical changes, not only in the stress systems, but also in brain development (Glaser and Weissman). In addition to the difficult problem of post-traumatic stress disorder (PTSD), we have to take into account the possibility of other types of mental illness as the consequences of child abuse. These include depression, eating disorders, and drug and alcohol problems. The combination of PET and fMRI represents a more remarkable example of the power of neuroimaging since the two have made it feasible to map accurately in vitro identifiable cortical fields, or networks. In a landmark NIH investigation of human cortical reorganization (plasticity), persuasive evidence was brought forward showing that the process of learning as a motor task involves a specific network of neurons. These neurons occur in the cortical field that is responsible for that particular task. Such findings are important partly because they provide evidence supporting the current notion that labor in the cortex is divided among ensembles of specialized neurons that cooperate in the performance of complex tasks. Cooperation, then, in this, sense implies crosstalk among ensembles and that signals are both processed and retransmitted to neighbouring ensembles. To understand the workings of these ensembles, much better spatial and temporal resolution in functional brain mapping is required. This can be achieved with an NMR instrument whose magnet is 4.1 Tesla or more.

This interdisciplinary work addresses the question, "What role should psychological conceptualization play for thinkers who believe that the brain is the organ of the mind?" It offers readers something unique both by systematically comparing the writings of eliminativist philosophers of mind with the writings of the most committed proponents of biological psychiatry, and by critically scrutinizing their shared anti-anthropomorphism from the standpoint of a diagnostician and therapist. Contradicting the contemporary assumption that common sense psychology has already been proven futile, and we are just waiting for an adequate scientifically-based replacement, this book provides explicit philosophical and psychological arguments showing why, if they did not already have both cognitive and psychodynamic psychologies, philosophers and scientists would have to invent them to better understand brains. (Series A)

demonstrates the physical, psychological, and social harm resulting from the label schizophrenic and the continuous need to reexamine the underpinnings and attitudes of psychiatry. Booklist Of all the books written about schizophrenianone is more comprehensive, accurate, thorough, and clearer in style and statement than John Modrows classic How to Become a Schizophrenic. Modrow, who is a recovered schizophrenic and is, perhaps, the unrecognized and unappreciated worlds foremost authority on this disorder, has performed a truly invaluable service and has made the major contribution to our understanding of the causes and cures of this pseudodisease. Robert A Baker, Ph.D., former chairman of the Department of Psychology, University of Kentucky; author of They Call It Hypnosis, Hidden Memories: Voices and Visions from Within and Mind Games: Are We Obsessed with Therapy? One of the best things Ive read on the subjectI am struck by the richness of the ideas and the research and the soundness of the conclusions. Peter Breggin, M.D., founder and director of the International Center for the Study of Psychiatry and Psychology; author of Toxic Psychiatry and Talking Back to Prozac a very important contribution to the field. Theodore Lidz, M.D., former chairman of the Department of Psychiatry, Yale University; author of The Origin and Treatment of Schizophrenic Disorders and Schizophrenia and the Family well researched and easily readable (a difficult combination to achieve)! Judi Chamberlin, author of On Our Own: Patient-Controlled Alternatives to the Mental Health System meticulously challenges all the major research that claims that schizophrenia is a biological disorder. Ty C. Colbert, Ph.D., author of Broken Brains or Wounded Hearts: What Causes Mental Illness Before reading the book, I was largely convinced that schizophrenia was primarily a brain disease. Modrow has forced me to take a second look, however, and reconsider the psychological causes of the condition. The Vancouver Sun it is ennobling that despite bad and discouraging treatment he was able to understand himself and others, and share that acquired knowledge in an accurate and helpful way. Bertram P. Karon, PhD., professor of clinical psychology, Michigan State University; author of Psychotherapy of Schizophrenia gives clear proof that theres real hope. Truly a remarkable book! Alan Caruba, Bookviews